Wednesday, August 19, 2015

"America's Bitter Pill" by Steven Brill - Review

What is the most frequent wish among people all around world? Most likely it is "to be, to stay and to become healthy". Compared to health everything else fades. We believe we can do anything if we are healthy. 

Universal health care law in USA, called Affordable Care Act (ACA of 2010), is a relatively new law. There are many myths about ACA, also known as Obamacare, after President Obama who singed it into law in March 2010.

This book by Steven Brill is an excellent review of how ACA came about. Steven Brill dissects pre- and post-ACA health care environments and explains what was accomplished by ACA and in what areas it failed to deliver.    

The book also explains how legislation in US is working why it is so susceptible to interference from outside interest groups (lobbyists).

Why is healthcare in US so expensive? According to Steven Brill's book 3 main categories determine health care cost in US: (1) cost of hospital treatment, (2) cost of medical devices and (3) cost of brand-name prescription drugs. Surprisingly, the role of health insurance companies are minimal in overall rise of healthcare costs.

I was disappointed to learn that Obamacare did little to modify these 3 major costly categories. Basically new law does not seem to make healthcare less expensive. It appears that without federal subsidies to cover portion of premiums, Obamacare would have been too oppressive for an average US resident. 

Still, as Steven Brill himself admit, when it comes to health, people rarely think twice whether to get treatment or not. Moreover, people want to get the best treatment available, no matter what it may cost. So, in this regard, by abolishing (1) pre-existing condition exception and (2) upper limits on health plan coverage, ACA law is first step towards right direction.

posted by David Usharauli

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